Group Therapy: The Intangible Benefits for Acquired Brain Injury

Friendships after Acquired Brain Injury

Nancy, Felix, Ted and Alex* shared more than their acquired brain injuries. They were all isolated from friends after their acquired brain injuries. Socializing was too much work. Friends didn’t understand. Friends stopped calling. It was hard to initiate a conversation with someone new. We heard the stories again and again. They were different faces, but the same stories. They all attended group therapy to help with their communication disorders.

After Group Therapy

We heard new stories: “Group is one of my most important appointments”, “When is the next one?”, “It was really great”, “Do you have Ted’s number?”, “She inspired me because if she could do all that with all her physical problems on top of her brain injury, and with a kid, then I can do it too.”

Our clients establish a new sense-of-self linked with renewed abilities to interact successfully with peers. We have seen so many positive changes in our clients. They have developed relationships with each other outside of sessions. Clients meet before or after sessions to continue the relationships that began in the sessions. Recently Felix (an extremely shy person since his acquired brain injury) participated in a presentation that was made possible through a relationship formed through group. The other group member inspired and encouraged Felix to get involved. Ted obtained a bus pass for the first time ever, as a direct result of wanting to attend group independently. This goal was not one that Ted had ever expressed before. Alex plays in a band and now Nancy has become inspired to try to play guitar again, “Alex is really good and he learned after his brain injury”.

Group Therapy offers more than just Practice

Friendships aren’t made overnight and having an acquired brain injury can make that dynamic even harder. Group therapy helps build confidence by allowing clients to practice important skills in a safer environment, and provides emotional support by way of a client realizing that he or she is not alone. The skills to make and maintain relationships are practiced, but there is So. Much. More.

Do you need some help getting back into socializing? If so, check out our groups online, or call us to discuss your individual needs. We would love to hear your story and see which of our groups is the best fit for you.

*names and some details have been changed to protect our clients’ identities

BobiTychynskiShimoda-220Bobi Tychynski Shimoda is a Speech-Language Pathologist with more than a decade of experience working with neurological communication and swallowing disorders. She has worked in a variety of settings including inpatient rehab, acute care, community, and private practise. She is highly skilled in assessment, and innovative treatment approaches.


Difficulties with Social Skills and Autism

Throughout my career as a Speech-Language Pathologist, I have always had an interest in the role that social skills play in the social, emotional and academic successes of children and teens.  Over time, I started seeing more and more people who struggled with social confidence and social skills. Most of these children and teens had been diagnosed with autism spectrum disorder (ASD) and some simply felt or been told that they didn’t do well in social situations. This is definitely a common challenge faced by all people with autism no matter what their language or cognitive skills. No two people will share the exact same pattern of difficulties with social skills. This is why autism is now commonly referred to as a spectrum disorder which represents a large range of abilities and difficulties found with those who have autism.

Difficulties with Social Skills Across the Ages


Most social difficulties for many children with autism can be identified in early childhood or even infancy. Some of the earliest signs are:

  • Limited eye contact
  • Responding to their name
  • Sharing attention
  • Difficulties with imitating

These above signs can become worse and children might shy away from social situations or avoid them all together. On the other hand, some signs may go undetected because they are similar to the behaviours seen in typically developing children going through the regular tantrums or being defiant.


For children who are unable to access early social intervention, the problems tend to develop as their social demands increase. They often have limited play skills and show little interest in playing with friends. Or, if there is an interest in engaging with other children, they may not have the appropriate skills to:

  • Initiate play
  • Respond to the play invitations to other children
  • Or to learn play through observations of other children
  • Attempts at social interaction is immature

When they do have friends, their friends tend to be very accommodating children who adjust to their need to control play. Difficulties with social skills and maintaining friendships as they get older can be very challenging given that typical children become less accepting of the one-sided nature of these friendships.


As children with autism age and move into high school, they continue to have difficulties with social skills and are likely to feel isolated from their peers. Schools often try to create an environment for acceptance and inclusion to help increase the potential for friendships. Often those who have high language abilities may have great self-awareness of their differences and a greater motivation to want to fit in. But, that being said, teens by this point may have faced social rejection and are more comfortable communicating with adults who encourage them in their specific interests or spend more time on their own.

What can you do to help someone with difficulties with social skills?

There are many different social skills interventions out there such as, video modeling, social stories and activity-based intervention to name a few. Cognitive Behavioural Training (CBT) can be used in teaching social skills, which involves increasing knowledge about the social world and at the same time increasing awareness of thoughts and feelings. One specific type of CBT is Social Thinking!

What is Social Thinking?

Social Thinking is what we do when we interact with people.  The Social Thinking approach (based on the work of Michelle Garcia Winner) focusses on helping individuals think strategically in social situations. It helps them to observe and consider their own and others’ thoughts and feelings.  It bridges the connections between thoughts, feelings and behaviours, paving the way for social skills that can apply to many situations.

Social Thinking also sheds light on academics; children who struggle in conversation, struggle to understand literature – not due to a lack of core skills in reading fluency and decoding – but rather, in perspective taking. Its main focus is on teaching individuals to think about how others perceive them.

When individuals are unable to interpret others’ perspectives, they may struggle with developing meaningful relationships. Social Thinking breaks down social concepts so that we can convey them in ways that are practical and logical.

Social Thinking is a language-based approach for individuals with social learning disabilities, not just specific to individuals with autism but anyone that may have ADD, ADHD, Nonverbal Learning Disabilities and/or Language Disabilities, ages 4 years through to adulthood.

For more information on Social Thinking or if you are interested in programming using Social Thinking contact us today about our March Break/Summer Camps or individual sessions!

AmyWebAmy Grossi is a pediatric Speech-Language Pathologist, practicing for over 10 years. Amy enjoys the area of early language, literacy development, apraxia and fluency. She has a passion for working with children with multiple developmental needs and implementing creative and interactive treatment sessions.

Friendship and Social skills: Why are they important?

shutterstock_50844475We, as humans, are in a world filled with people. We have no choice but to interact in some way throughout our lives. With increasing technology, there is a decreasing emphasis on social skills. I see people every day, both at work and in everyday life, that need some sort of assistance with social interaction. Whether we are interacting face-to-face or via text or some other online platform, we need to be able to communicate effectively.

Social Skills or Interaction skills

The skills I’m talking about aren’t necessarily something you need to think about. People over the age of around 30, don’t usually have difficulty in social situations. We learned from a young age how to interact because we did it regularly. Instead of texting our friends, we had to go knock on their door, say hello to their parents and ask if our friends could come and play. Little did we know that these skills were something we’d use throughout life in many situations! Greetings, salutations, taking turns, and asking questions are just a few of the skills that we learn through observation and imitation when we are young. Now that technology has seeped into our lives, things are a bit different. Texting has changed our dictionary – Yes, the acronym LOL is in the scrabble dictionary now!! With all of these changes, there has been a decrease in the emphasis of face-to-face social skills. Why or when are these important? We need these skills to get a job and interact with people every day – interviews, in a restaurant, at the movies, interacting with co-workers or class mates, just to name a few. If we don’t know what to do, then how will we do it?


Friendship is just one part of social interaction.  I have had some young clients tell me “I don’t need friends”. I beg to differ! Our friends are the first extension of our family, especially early in life. We practice social skills with them and they are usually an unbiased and unjudging venue for that practice. This is also how we learn to interact with people outside of our family – we learn that although you might hug and kiss your mom and dad, you don’t do this with friends – we are learning socially acceptable boundaries. This also teaches us skills that will transfer over into working environments when we are older. It’s also the first avenue where we learn to negotiate, express our opinions and learn to argue our point of view as well as understand other’s point of view. All of these skills will help us become a good worker and an advocate for ourselves or others in the future. I’m not saying you need 1000 friends on Facebook, I’m saying you need a few close real-life friends that you trust and trust you to help navigate this crazy world of ours!

What do I do to help my kids learn these social skills?

Have a conversation with them. Set aside time to demonstrate these skills to them and show them what they should be doing. For example, make dinner time a “no technology” time so you can actually interact with each other. Ask them questions about their lives “tell me your favorite part of the day today”. Show them how to listen and answer “my favorite part was ____ because ____”. Play outside – no technology! Teach them the games you used to play, run, skip, jump, play hide-and-go-seek! Have your child interact with the people and things in their world and set a good example for them! Don’t sit on your device, actually interact with people, on the phone or in person and show your kids how, otherwise, they might not ever learn.

For more ideas or to ask questions, feel free to comment!

LynseyWilson-220Lynsey Wilson is a Communication Disorders assistant with experience treating a wide range of clients with varying ages and disorders. She also has her Early Childhood Educator certificate and specializes in working with pediatric clients. Lynsey enjoys working with a variety of age groups to keep her on her toes!